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The Impact of Reforms on Public Trust: Understanding the Complications and Solutions

This piece examines how needed reforms, particularly in the NHS and public sector, can inadvertently damage public trust. It discusses the transfer of responsibility from the state to individuals, emphasizing the constraints of spending and growing demands. While these reforms aim to enhance efficiency and accountability, they often overlook the social dimensions of trust between citizens and institutions. Various proposed solutions, such as improved communication and participatory governance, are explored, alongside the need for reforms to be ongoing and well-resourced to truly restore public trust.

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The Impact of Reforms on Public Trust: Understanding the Complications and Solutions

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  1. How needed reforms may damage trust Peter Taylor-Gooby p.f.taylor-gooby@kent.ac.uk

  2. The issue: e.g. NHS reform

  3. Public sector reform • Keynote of reform: transfer of responsibility state → individual • For excellent reasons • spending constraints/ growing demands • limits on state authority • assertive (and richer) citizens • Cf EU Social Agenda 2001 → 2008

  4. UK approach • Labour market activation; pensions • ‘New public management’ • competing providers • consumer choice • budget allocation • targets, regulation, information, from top • Implicit theory: people as social actors → individual rational action

  5. The trust malaise • IRA: alignment of interests • Social: shared values/ commitment • Combination: both contribute • Reforms pursued on good grounds, and which (often) achieve targets, may damage trust for reasons not obvious to reformers • [NB: many other factors influence trust]

  6. Why do we want trust? • Trust as a trap (and a commodity) • But helpful for legitimacy of government and continuing public provision • Pressures from future challenges • Critical trust, informed trust

  7. Solutions I • O’Neill/ Neuberger: reassert trust in professionals, but how to go back? • Furedi: embrace individual self-confidence, but where is public provision? • Seldon: face-to-face trust, but limitations • FSA I: improved information, but hard in a diverse, plural society

  8. Solutions II • Giddens/ Weale/ Renn: reform democracy, citizens’ juries → deliberative institutions • Much interest, many expts, more concerned with informing rather than directing policy • E.G. Bristol health, BC constitutional reform, Wenling, Rowntree experiments, Newcastle centre, ‘people and participation’, etc • Central and local govt interest – GM Debate • OECD, IRGC, Risk Agenda

  9. No easy solution? • All initiatives address particular issues, and are consultations • Not clear this will rebuild trust • Involves elements of information, subsidiarity, engagement exercises etc. • Has to be continuing and embedded • Can’t be cheap - • which returns us to cost-effectiveness!

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